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Home My WebLink About0319 ARROWHEAD DRIVE - Health x 3\19 Atr,owhead Hyannis ° A 27Q=065 1 1 i I i I j LOCATION SEWAGE PERMIT NO. VILLAGE !.M INST LLER'S NAME i ADDRESS i -&oca - -7 y /�k;e _ram S BUILDER OR OWNER aS s DATE PERMIT ISSUED " DATE: COMPLIANCE ISSUED�� /z /y� ,, . j I � �.�' �?S�� , � � _ ,� C , /-�.� .� . � !7' � '� � N . '� `, � � � \Fg" �-,. , ��' �.�. � . � 'Y\ � � • �/��` �� Z No... .................. THE COMMONWEALTH OF MASSACHUSETTS BOARD PF ,l,-I/ETAL/TH W ...:....OF.............. ..R�u l..t .�J./' ................ Applira-tiun for Disposal Works Tonutrur#iun Prrutit Application is hereby made for a Permit to"Construct ( ) or Repair ( to-J an Individual Sewage Disposal System at: .._.A. .......... .... .........................................:........................................................ Location•Address or Lot No. 04:7S. / .............................................................. .... ........_... ................ Owner � •Address ................................ ..................................------... ........................................... Installer Address Q Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms................ ....................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No: of persons............................ Showers ( ) — Cafeteria ( ) a4 Other fixtures ............................................ W Design Flow.............................................gallons per person per day. Total daily flow-_-_-:...._.._._________.._.__._............gallons. WSeptic Tank—Liquid'capacity............gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area...................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by..............................................•--•-•-•.....-----•--••---_. Date....................................... Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water......................... (z, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ Descriptionof Soil......................................................................................................................................................................... x W ---•---.......••••••------••-•--•------•---•---•-•--•_..... UNature of Repairs or Alterations—Answer when applicable.------ /a_.....�O o__...- -------------------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been is ed by the board of ealth. Signed.....,.. .... .......... . .................................. ........ Date o Application Approved By......... —4 , .....,. . ..---.......................... ......... Date Application Disapproved for the following reasons:............................................................................................................... --------...•----•••-•-•-•....-•••----•-•-=•--•-•....•-••••••.....:........•••••--••-•---••--•--•-•--.........................•-•-•...-•-•--•-••---•--••-••-------•-------=•-••------•----•••----......--- Date PermitNo.......................................................... IssuecL....................................................... Date • THE COMMONWEALTH OF MASSACHUSETTS BOAR® QF HEALTH ... ..jr9 . ....fir......................... AVVIirtttinn for Disposal Works Tonstrurtiun Prrmit Application is hereby made for a Permit to Construct ( ) or Repair ( L an. Individual Sewage Disposal System at: �� - ..........-•...................................................................................... Location-Address or Lot No. ---------------------------'._...---•--.......•---•... .--- ................... w Owner / Address Installer Address UType of Building Size Lot.................... .....Sq. feet .+ Dwelling—No. of Bedrooms..............�. � ..................Expansion Attic ( ) Garbage Grinder ( ) Paa. Other—Type of Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( ) Other fixtures -----------------------•• -----._..._._.._-•-...._..._._ -•-•---•---•....................••-------•-- w Design Flow............................................gallons per person per day. Total daily flow............_._.____...___....._.__......___gallons. WSeptic Tank—Liquid capacity....._..__._gallons Length________________ Width................ Diameter................ Depth................ x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area._..................sq. ft. Seepage Pit No.........:............ Diameter.................... Depth below inlet..................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by..................•_____--.•__••_-•-_....__._____-____.--.--_.--_.._.__._. Date........................................ Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water....................... rX Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ ---------------------------- •--------- •--••----•--......_.......... -.................................................................................... 0 Description of Soil--•••---••-----•--•-----••-••-•-•-•..............•----------...._...----••----•••--•--•--•--•---•-•----•------•-----•----•-•-•--•-•-•---•••--._._._.....----------_----• x U ..............................-.......................................................................................................................................................................... w U Nature of Repairs or Alterations—Answer when applicable....... ----.. U1 ...--- :-{,;n .i-------------------- ••----....----•----------•...............................•••-----------•-__.._.__.__..........__..___....,-...._....----------------••---------------___._.--__.._._..........•---•-----.....----•=----- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage-Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been is ed by the board of ealth. Signed i2��(yQ = ------•-•1 Dr� � Application Approved By-------...... -- ->•-•--��f--� ----•--••-, �1��7 Date Application Disapproved for the following reasons:............................................................................................................... _ -•--•••.... . ... ••-- •----......--••----•---------------------------------•---•'------------._.....-••••----•-------------....------•---•-----••--•----._.- ---•-------- Date PermitNo....................................................... . Issued............................................. Date THE.COMMONWEALTH_O +fv1ASSACHUSETTS BOARD -OF'' HEALTH .............. t,c ....OF............. .4.�:�1.... '.' !T./Q ........_... T ertif iratr of Toutpliattrr THIS IS T9 CERTIFY, That he Individual Sewage Disposal System constructed ( ) or Repaired ((� �= ` Installer has been installed in accordance with the provisions of TI7lg�1 of The State Sanitary Code as des ibed in the application.for Disposal Works Construction Permit �o______________________ _ _e�-___. dated_...-_-___,1�'4a Z._3.............. THE ISSUANCE"OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL,-FUNCTION SATISFACTORY: DATE...........::... �i 02 Inspector THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH '3� ��Z .c ....oF.........�1--9 r .S._l!�?f/�.................. /D No... ........ ....... FEE....__-_.___............ Disposal Vorks Tonstrudion rrmit Permission is hereby granted_..____. 1�1Q_v -�__-•••---_..••__._ �_A,-,. �/� -•-----•-•....................•-•--•--...__._.__......_.........._.... to Construct ( ) or Repair (4+an Individual Sewage Disposal System treet as shown on the application for Disposal Works Construction Permit No____________________ Dated..... ........ ................................................. , DATE............................... �� ................... oard of Health FORM 1255 A. M. SULKIN, INC., BOSTON f i Now I 4 1 co LAI ie rs i — _ ........... _ (7 FA,7 ma oiF��My f cx LL '---- ------- --------• - �. I bib _ .. r 7 Mo _ �i+ + ,� • C �� .x .ice M i w P .0:1ECT TITLE Is 4�1 I N.tc.) _............--VZ- I ZQ1 3 1u [a rw;n.-K310 1' v` V. 3 t J -• PREPARED FOR Cen l Cofi*w1on Company' 11% - I Sieve Deviin•Presidem "The E ciaement is Amildbig" 820 Meln Street,Gotult. MA•808-42Q-1'UC ,} *-mall:centml=nsUucUonw*grnall.com �6 Wobsite:www.ran tralcapecom struction-corn r� Zr�(o -t. Z-43(� h scat F,,,�L— se( DATE _J LY l�-- ---- DWG NO. DESIGN - CHECK--- DRAWN